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Exercise Healthy Living Physical Activity

The side-effects of exercise. Some of them are positive!

abreast in a boat team

I recently wrote of the many benefits of regular physical activity. These include improvements in cardiovascular fitness, sleep quality, mood and anxiety levels and reductions in the risks for heart disease, stroke, diabetes and osteoporosis.

In fact, doctors across B.C. have been writing their patients prescriptions for exercise.

Of course, every treatment has potential side effects. Fortunately, these risks are by far outweighed by the benefits of exercise.

Musculoskeletal injuries – strains, sprains and fractures – are the most common risks of exercise. The risks depend on your chosen activity, where you exercise and your individual risks. To reduce your risk for injuries, begin at a lower intensity (i.e. walk before you run, hop before you leap), use proper equipment (i.e. appropriate footwear, helmets and other protective equipment), a safe environment (i.e. a designated bike path) and expert assistance (i.e. coaching, training and supervision).

The less common but serious risks of exercise include irregular heart rhythms, heart attacks and respiratory distress in those with asthma or chronic lung disease. Another rare risk is muscle injury so severe that it results in the rhabdomyolysis, the breakdown of muscle cells and kidney failure.

To avoid these more serious complications, understand the risks of extreme exercise, including marathons and vigorous exercise in extreme weather conditions – and if you could be at increased risk by personal or family history, consult with your doctor.

There is appropriate exercise for everyone but it has to be individualized according to your interests, physical condition and personal medical history. Like all prescriptions, the dose is important.

You can overdose on exercise. Yes, regular aerobic activity with its release of feel-good endorphins can be addictive. You’ll know you’ve been overexercising if you are getting more frequent colds, feel achy all over all the time, feel exhausted every day and suffer frequent injuries.

Often the side effects of exercise are positive and unexpected. Almost 20 years ago, Dr. Don McKenzie of the McGavin Sport Medicine Centre at U.B.C. put together a study group to dispel the myth that strenuous upper body exercise may cause lymphedema in women who have had breast cancer.

After one year, no one in the study group developed lymphedema. As a positive side effect, the women discovered that they loved paddling together so much that they founded the Abreast in a Boat Society, the world’s first dragon boat team comprised of breast cancer survivors.

The mission of the now approximately 165 members who paddle on five crews throughout the Lower Mainland is to raise awareness of breast cancer and to demonstrate that women diagnosed with breast cancer can enjoy full and active lives. For more information about these inspired women who serve as living symbols of hope, visit their website at http://www.abreastinaboat.com.

abreast in a boat

The safest way to begin a more active lifestyle is to join the Doctors of B.C. on Saturday, May 3rd at 9:30 am for a free and fun 2 km walk at Vancouver’s Kitsilano Beach Park. I’ll be there with many of my colleagues along with our patients. There won’t be a safer place to walk anywhere in town.

All members of the public are invited, but come early to get your free pedometer. For more information about this event, check online at www.bcma.org/walk-with-your-doc.

Dr. Davidicus Wong is a family physician and Physician Lead of the Burnaby Division of Family Practice. 

 

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Burnaby Division of Family Practice Empowering Healthcare Exercise Healthy Living patient-doctor relationship Physical Activity Positive Change Preventive Health

The Evolving Patient-Doctor Relationship

Dr. Davidicus Wong with patients, Donna and Albert Gomes
Dr. Davidicus Wong with patients, Donna and Albert Gomes

Medicine is a calling. For dedicated physicians, our responsibility to our patients, profession and society extend beyond regular working hours and occupy our minds outside of both hospital and clinic.

Traditionally, the sacred moment is the time we spend with each of our patients, our attention focussed on their wellbeing. Yet the patient-doctor relationship continues to evolve.

In the past, physicians used to give orders – for their patients to lose weight, exercise, eat better, quit smoking, limit alcohol and take their prescription medications, and when their patients would return many months later not having followed those orders, they would be labelled “noncompliant” and the doctor would repeat the same orders.

We no longer use that term; it harks back to the days of medical paternalism. The doctor doesn’t always know best. We have expertise in the science of medicine and experience in what has worked for most patients; however, patients are the experts on their own lives, their values and their priorities.

When patients fail to follow through on goals we have set together, I don’t blame them. Rather I question whether I had helped them choose the best goals for them. Were they the goals that matter most to the individual? Did I provide sufficient support for success?

Those old doctor’s orders were actually good recommendations for activities that would promote health, but achievable goals must appeal to the patients’ values and be appropriate to their circumstances. They must be tailored to the individual.

The Practice Support Program has been teaching family physicians new tools to help our patients make lasting positive changes. When most people think of health care, they think of the tip of an iceberg – acute care in the hospital, and that is where a large proportion of our tax dollars is spent. Yet 90% of professional organized health care takes place in the community, for example, in primary care clinics. Family physicians provide much of the medical care for most patients.

But professional health care itself is just the tip of an even greater iceberg. Self-management is the care that patients provide to themselves through the monitoring of their chronic conditions, nutrition, physical activity and self-education.

The key to improved health is to better support patients in their self-care.

The doctor-patient relationship continues to evolve with the advent of the Divisions of Family Practice throughout the province. With the support of the General Practice Services Committee, family physicians have formed non-profit organizations to improve primary care in their communities.

Dr. Shelley Ross leading the WWYD pack
Dr. Shelley Ross leading the WWYD pack

On Saturday, May 3rd, the Doctors of B.C. (formerly the B.C. Medical Association) will demonstrate their care and commitment to our patients and community with a free and fun 2 km walk at Kitsilano Beach Park in Vancouver at 9:30 am. I’ll be there with many of my colleagues along with our patients.

Even if your doctor isn’t there, you’re welcome to attend. All members of the public are invited, but come early to get your free pedometer. For more information about this event, check online at www.bcma.org/walk-with-your-doc.

Dr. Davidicus Wong is a family physician and Physician Lead of the Burnaby Division of Family Practice.

Drs. Davidicus Wong, Karime Mitha and Shelley Ross at the BCMA's Walk With Your Doc May 4th, 2013
Drs. Davidicus Wong, Karime Mitha and Shelley Ross at the BCMA’s Walk With Your Doc May 4th, 2013

 

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Balance Emotions Empowering Healthcare Exercise patient-doctor relationship Physical Activity Positive Change Preventive Health Your Goals

Doctors Prescribe Exercise: The Benefits of Physical Activity

During the week of May 3rd to 11th, 2014, doctors throughout British Columbia will be promoting physical activity and literally walking the talk with their patients in a variety of community events.

On Saturday, May 3rd, the Doctors of B.C. (formerly the B.C. Medical Association) will kick off the week with a free and fun 2 km walk at Kitsilano Beach Park in Vancouver at 9:30 am. I’ll be there with many of my colleagues along with our patients.

Even if your doctor isn’t there, you’re welcome to attend. All members of the public are invited, but come early to get your free pedometer. For more information about this event, check online at www.bcma.org/walk-with-your-doc.

Throughout this month, doctors across the province will be writing prescriptions for exercise, encouraging patients of every age to be physically active.

To celebrate the World Health Organization’s Move for Health Day on Saturday, May 10th, the City of Burnaby has organized a large number of free events including community walks in many of our neighbourhoods, canoe lessons, boot camp, swimming and the grand opening of the outdoor fitness circuit at Central Park. For more information check the City’s website at http://www.burnaby.ca.

Why the big push for everyone to be more active?

Here are 7 proven benefits of regular physical activity.

1. It decreases your risk for heart disease, stroke, high blood pressure, diabetes and cancer. Exercise also plays an important role in managing and improving chronic health conditions.

2. Physical activity prevents weight gain and can help maintain a healthy weight. It complements healthy nutrition.

3. It improves the fitness of your heart, lungs and muscles. Regular physical activity conditions your body to function better making everyday activities easier.

4. Regular physical activity prevents falls and improves cognition in older adults. When your limbs and brain are accustomed to movement, your balance, agility and ability to react improve. When blood flows better throughout your body, it also provides better circulation to the brain. A healthy body promotes a healthy brain.

5. Weight bearing activity (i.e. walking) helps maintain bone density, reducing your risk for osteoporosis and fractures.

6. Exercise improves sleep. Although vigorous exercise just before hopping into bed may be too stimulating, activity earlier in the day can improve the quality of your sleep.

7. Physical activity improves emotional wellbeing. For a number of years, psychiatrists have been prescribing exercise to their patients suffering from the symptoms of depression and anxiety.

Exercise has been shown to reduce stress hormones, such as cortisol, and increase endorphins which are natural painkillers and feel-good chemicals. Exercise also promotes a sense of accomplishment and self-confidence. Physical activity can provide social benefits; you can meet regularly with friends to keep you motivated or make new like-minded friends while enjoying your spin class, swim or Zumba sessions.

Our bodies were meant to move. When we don’t, our health suffers; when we do, we thrive.

Over the next week, look for simple ways you can increase your level of physical activity. You could walk or bike to school or work – or simply get off the bus a few blocks further from your destination. You could buy a bright new umbrella, embrace our rainy days and choose to do an extra walk each day. Take the stairs when you can.

At home, walk while you talk on the phone. Spend less time in front of the computer or TV but move around while you watch your favourite shows. Dance with the music you love.

In upcoming columns, I’ll discuss specific exercise recommendations, the risks of exercise and tips on staying motivated and achieving your fitness goals.

Drs. Davidicus Wong, Karime Mitha and Shelley Ross at the BCMA's Walk With Your Doc May 4th, 2013